On rumination depression and anxiety

Most of those with panic, anxiety, or depression know exactly what obsessive thinking is like. "Something's wrong with my heart. My heart's not beating right. It's skipping beats. Didn't that basketball player collapse on the court and die because his heart was skipping beats? What if I get to the supermarket, and collapse right their in the frozen foods aisle? I'll be so far from home! And what if nobody helps me? I know that's not really going to happen. But my heart's skipping beats -- what if it does? What if I have a heart attack, and collapse, and die?"

That kind of thing.

This blog post, which discusses the correlation between depression and obsessive thinking (a correlation that is, of course, just as strong between obsessive thinking and panic and anxiety), opens with a wonderful description by Sylvia Plath of depressive rumination: "I am terrified by this dark thing/That sleeps in me; All day I feel its soft, feathery turnings, its malignity." It goes on to say:

One theory is that ruminators have a particular cognitive style, a neuronal inflexibility that distorts the normal executive functioning of the brain. Two psychologists at the University of Colorado, Boulder, decided to explore this idea in the laboratory, to see if they could identify the specific deficit underlying such perseveration. Anson Whitmer and Marie Banich gave several hundred young adults a widely used test to measure their ruminative tendencies. The ones who scored high were not clinically depressed, but they did display this signature cognitive style.

Then the psychologists gave both the ruminators and those who scored very low on this trait a complicated mental test in which they were required to pay attention to certain stimuli, switch their attention elsewhere, suppress thoughts and replace them with new ones, and so forth. The idea was to sort out two ways that normal attention can malfunction. Sometimes we simply can’t shake an unwanted thought, hard as we try. At other times we cannot switch from one way of thinking to a newer, fresher way. These sound similar, but to the brain’s executive neurons they are distinct. The subjects were required to respond as rapidly as they could, in order to tap into these fundamental, unconscious processes.

The results, as reported in the June issue of Psychological Science, were plain. The ruminators, when compared to normal thinkers, had much more difficulty suppressing unwanted thoughts. Imagine trying as hard as you can not to think of the death of a loved one or a failed relationship--or trying to expel the embodiment of your melancholy--and failing; that’s the clinical equivalent of these lab results.

But Whitmer and Banich went one step further. They studied the same two cognitive processes in two other kinds of rumination, namely angry rumination and intellectual reflection. Angry rumination is, well, think of the rude guy who just cut you off in traffic—and the visceral feelings you still have, hours later. Reflection, as the word conveys, is good rumination; it’s peaceful and creative focus on an idea.

It turns out that, as different as they are emotionally, angry rumination and intellectual reflection are cognitively similar—and cognitively distinct from the distorted thinking of depression. Both involve difficulty switching to a new topic, rather than difficulty inhibiting a negative thought. In a sense, depressive rumination is an avoidance problem, while angry rumination and reflection are characterized by uncommon persistence in a way of thinking.

Fascinating stuff. Many thanks to the We're Only Human blog.